Oncology Nurse Reflects on Three Months in Haiti

Robert Benvenuti, BSN, RN, of the Bone Marrow Transplant Unit on Tower 4C, has been an oncology nurse for his entire nursing career, but applying his skills and knowledge in a setting with limited resources and less advanced treatments than Boston provided an interesting-and rewarding-challenge.

This past fall, Benvenuti had the opportunity to help shape a fledgling oncology clinic in Haiti through the Dana-Farber Cancer Institute's Global Nursing Fellowship. Prior to his visit, the clinic had moved from a hospital in Cange, Haiti, to the new Hôpital Universitaire de Mirebalais, the country's first teaching hospital, where Benvenuti was assigned for three months.

"I mentored Haitian nurses there and helped train new nurses just beginning in the clinic," he said. "They mainly needed reinforcement in the administration of chemotherapy and help in the day-to-day operations of running the clinic."

Each week, Benvenuti and his Haitian colleagues had a conference call with nurses at the Dana-Farber/Brigham and Women's Cancer Center to discuss treatment for patients with breast or colorectal cancer. "We had to base our treatment plan on what we could actually offer at the clinic, which did not include certain chemotherapies and radiation," he said. "That made it drastically different from what we would provide for patients back in Boston, where treatment options are much more extensive."

There were also fewer supplies than nurses have access to here at BWH. "It's amazing what you can do with fewer supplies and resources," Benvenuti said.

For example, nurses at the clinic were responsible for mixing the chemotherapy, while at BWH, pharmacists handle that important task. Infection Control measures were also different. "There were no alcohol wipes, but instead we used a bottle of alcohol and cotton balls, which cost less than the individual wipes," he said.

Despite the differences, the core practices of nursing spanned geographic and cultural boundaries. "Patient education is really important," he said. "And knowing the patients is vital, as it is at the Brigham and everywhere nursing is practiced."

One of the important health issues facing Haiti is raising awareness of cancer early, while treatment is still possible. Many of the patients who came to the clinic had been diagnosed too late. "Some live in very rural locations and couldn't access treatment after they were diagnosed, or the medications available were too expensive," Benvenuti said. "We provided palliative care, pain medications and dressing changes to help these patients be more comfortable at the clinic."

Benvenuti hopes that people will get diagnosed earlier, as awareness about cancer is raised. While in Haiti, he sought to help with this by holding educational events for patients to learn more about breast cancer during Breast Cancer Awareness Month in October.

Overall, he says the fellowship experience was extremely rewarding. "I got to interact with people from all disciplines, and because it's a smaller staff at the hospital, I was immersed in all aspects of care. Haiti is a very lively country with a beautiful culture," said Benvenuti, who still keeps in touch with staff at the clinic. "Living there, and having this experience, was incredible."